Welcome to Employee Benefits! We strive to provide exceptional customer service to our employees. Here, you will find important up-to-date information regarding employee benefits, which includes plan information, enrollment forms and contact information for individual insurance carriers, as well as important enrollment procedure guidelines.
Office Hours 7:00 am-4:00 pm
Eligibility and Enrollment Guidelines
Who is Eligible for Coverage?
Employees must work at least fifty percent of their assignment or more to be eligible for medical coverage. Employees who work full-time or part-time are eligible for medical, dental, vision and life insurance coverage.
The terms "family member" and "dependent" are used interchangeably. Eligible family members include:
- Registered Domestic Partner
- Children (natural, adopted, domestic partner's or step) up to age 26
- Children, up to age 26, if the employee has assumed a parent-child relationship and is the primary care parent
- Certified disabled dependent children age 26 and older
Ineligible family members include:
- Children age 26 and older
- Disabled children over 26 who were never enrolled or who were deleted from coverage
- Children of a former spouse/registered domestic partner
Enrolling Yourself and Eligible Family Members
Employees - have 60 days from the date of their initial appointment to enroll or decline to enroll yourself or yourself and all eligible family members. The effective date of coverage is the first day of the month following the date your completed enrollment form(s) and any necessary supporting documents are received by the Benefits Office. Incomplete enrollment forms will not be processed and may delay coverage.
Spouse/Registered Domestic Partner - may be added to your health plan within 60 days of your marriage/registration. You are required to provide a copy of your Marriage Certificate or Certificate of Registration of Domestic Partnership and spouse's Social Security Number. Your new spouse's/partner's coverage will become effective the first day of the month following the date the Benefits Office receives enrollment form(s) and copy of Marriage Certificate/Certificate of Registration of Domestic Partnership. Incomplete enrollment forms will not be processed and may delay coverage.
Newborn children - must be added within 60 days of birth. Newborn coverage is effective from the date of birth. The birth certificate received from the hospital is sufficient for enrollment but you are required to provide a copy of the office birth certificate within 90 days of birth. Incomplete enrollment forms will not be processed and may delay coverage.
Newly adopted children - should be added within 60 days of physical custody. Coverage is effective from the date physical custody is obtained. Must provide birth certificate and legal documentation. Incomplete enrollment forms will not be processed and may delay coverage.
Step children or Domestic Partner's children - under the age of 26 may be added within 60 days of your date of marriage or registration of partnership. Coverage will begin the first day of the month following the date the Benefits Office receives the enrollment form(s), birth certificate and marriage certificate. Incomplete enrollment forms will not be processed and may delay coverage.
Parent-Child Relationship - should be added within 60 days of certification. Must compete and submit Affidavit of Parent-Child Relationship. You will be required to re-certify periodically, upon request.
Disabled children 26 and over - who are incapable of self-support because of a medical or physical condition may be eligible for enrollment. The disability must have existed prior to reaching age 26 and continuously since age 26, as certified by a licensed physician. You are required to complete and submit a Member Questionnaire for the CalPERS Disabled Dependent Health Benefit and the physician is required to complete and submit a Medical Report for the CalPERS Disabled Dependent Benefit. The initial certification of the Disabled Dependent must occur within 60 days before and ending 60 days after the child's 26th birthday for current enrollees OR within 60 days of a newly eligible employee's initial enrollment in the CalPERS Health Program, whichever applies. Upon certification of eligibility, the dependent's coverage must be continuous without lapse. You will be required to submit an updated questionnaire and medical report for re-certification periodically, upon request.
Insurance Plan Information, Rates and Forms
2024 Health and Welfare Premiums- BTA Only
2024 Health and Welfare Premiums - CSEA January only
2024 Health and Welfare Premiums-CSEA/ BASA February-December
2023 Health and Welfare Premiums
CalPERS Anthem Blue Cross HMOs (Traditional and Select)
CalPERS Anthem Blue Cross PPOs (Platinum formerly Care and Choice and Gold formerly Select)
CalPERS Blue Shield HMO (Access + and Trio)
CalPERS Health Net of California HMOs (Salud y Mas)
CalPERS Kaiser Permanente
Delta Dental PPO and DeltaCare USA HMO
VSP Vision Care
Cigna Employee Assistant Plan
California State Teachers Retirement System - STRS
California Public Employees' Retirement System - PERS
Burbank Teachers Association - BTA
California School Employees Association - CSEA
American Fidelity Assurance Company - AFA
The Standard Insurance Company
Last revised 2/9/2024